Cooley Dickinson Hospital resolves allegations of unnecessary testing

Hampshire County
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BOSTON (WWLP) – Cooley Dickinson Hospital in Northampton has agreed to pay $11,332 to resolve the allegation that it submitted claims to Medicare and Medicaid for medically unnecessary testing.

According to the Office of U.S. Attorney Andrew Lelling, Cooley Dickinson allegedly created tick-borne disease test “panels” through which physicians and nurse practitioners could order more than one tick-borne disease test.

People can contract tick-borne diseases, such as Lyme disease, anaplasmosis, ehrlichiosis, and babesiosis if bitten by specific ticks infected with bacteria, viruses, or parasites. 

When a physician and/or nurse practitioner selected a testing panel in the ordering system (as opposed to manually selecting each medically appropriate tick-borne disease test), an order went to Cooley Dickinson’s laboratory to test for all of the tick-borne diseases programmed into the testing panel, even though the panel included tests for diseases caused by ticks that were not likely to be present in the geographic region where the individual was bitten so that the tests were not medically indicated by the patient’s symptoms.

Office of U.S. Attorney Andrew Lelling

The government alleges that between July 1, 2014, and June 22, 2017, Cooley Dickinson submitted claims to Medicare and Medicaid for blood tests used to detect tick-borne diseases when the tests were not necessary.

“This settlement is another reminder of how whistleblowers can help the government identify improper billing practices among health care providers,” said Lelling.

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